There's No Silver Bullet for the U.S. Testing Problem. But a New Saliva Test Offers Hope
I have a confession: I’ve never been tested for COVID-19, or for antibodies to SARS-CoV-2, the virus that causes the disease. In that regard, I’m like the majority of Americans. According to the COVID-19 Tracking Project, there have been about 66 million total tests administered in the U.S. Even if each of those tests was for a different individual—highly unlikely, since many people in high-risk situations are tested weekly or even more often—that would still mean only about 20% of Americans would have been tested.
I’m personally in a low-risk situation: I live by myself; I’ve limited social interaction to only three or four close friends and family; and I can work from my apartment, meaning I really only leave for groceries and other essentials. I’ve not had any symptoms that would suggest an infection (though of course you can be an asymptomatic carrier and spreader of the virus). I haven’t been to a restaurant or bar or any other public venue in over four months; I don’t even really like to go to public parks, despite the generally good social-distancing behavior of my neighbors. And I’m never in proximity to children or the elderly or the chronically ill. So, I haven’t felt it necessary to get tested.
However, there’s another reason I haven’t gotten a test: there aren’t enough of them. After hearing so many horror stories of two-week delays to get your results (which render them nearly useless in the grand scheme of things), I just haven’t felt it was worth the added risk of going out to get one. I have also worried that my taking a test would be one less test available to someone else who needs it more. Perhaps that’s irrational. But as I mentioned in last weekend’s edition of this newsletter, testing in the U.S. has fallen significantly in recent weeks. Across the country, testing infrastructure is patchwork, with inconsistent and unpredictable access and efficacy—it is so chaotic that when my colleague Emily Barron set out to map average test-result wait times by state, we couldn’t find any way to do so in a way that would adequately represent the messy reality. As Rachael Liesman, director of clinical microbiology at the University of Kansas Hospital, memorably put it: “It’s The Hunger Games for laboratories.”
It’s clear we need more tests and, especially, more tests that can give results rapidly. Over this weekend, there was some good news on this front, as the U.S. Food and Drug Administration took a fairly big step towards this goal by granting an emergency use authorization to an inexpensive saliva-based test, called SalivaDirect, developed by Yale University researchers. There’s no silver bullet for the testing problems in the country, but SalivaDirect has the potential to increase testing capacity significantly. For one thing, it bypasses a step used in other tests that requires expensive chemical reagents (of which there have been ongoing shortages). For another, Yale won’t commercialize SalivaDirect; labs across the country will be able to use the testing protocol immediately, which Yale says should only cost $10 a person.
Though estimates range (and change as the pandemic ebbs and flows), the Harvard Global Health Institute's latest recommendations were that the U.S. needs to be running 4 million tests a day—a far cry from the 700,000 or so the country has been averaging recently.
An affordable, scalable, and rapid test like SalivaDirect—STAT News reports that Yale can run approximately 90 samples in fewer than three hours in a lab, and that larger labs should be able to run far more at similar speeds—could play a significant role in increasing national testing capacity.
Of interest as well: the research that led to SalivaDirect was funded by the National Basketball Association—which will begin the playoff portion of its “bubble season” experiment tomorrow. It’s been surprisingly effective so far, especially compared to Major League Baseball, which has regularly had to cancel games due to outbreaks on their teams. Every Wednesday, the NBA Players Association, announced the latest testing results for all the players in the “bubble”—the NBA campus in Orlando, Fla.—and this past week, of 342 players tested, zero came back with positive results.
Every player, staff member, and auxiliary personnel (like media, support staff, etc.) in the bubble is tested regularly, while limiting interactions with only others in the bubble, and staying in a geographically circumscribed area. If anyone were to develop COVID-19, they’d be discovered almost immediately, and it would be easy to figure out who they’d come in contact with recently. Of course, this isn’t scalable in any meaningful way for the entire 330 million people who live in the U.S. But it does suggest that with the right testing tools, and with a population that buys into a strict social distancing attitude, it is possible to control this virus.
OVER THE WEEKEND
Congressional Democrats Made Clear the Postal Service SNAFU Needs to be Handled
Earlier today, Democrats in the U.S. Congress called postmaster general Louis DeJoy and chairman of the USPS board of governors Robert Duncan to testify at a House committee hearing about disruptive changes at the Postal Service on Aug. 24. The top-ranking party leaders, House Speaker Nancy Pelosi and Senate Democratic Leader Chuck Schumer, made crystal clear their reasoning and intentions, so I’ll let them say it in their own words:
“The President has explicitly stated his intention to manipulate the Postal Service to deny eligible voters access to the ballot in pursuit of his own re-election. Alarmingly, the Postmaster General—a Trump mega-donor—has acted as an accomplice in the President’s campaign to cheat in the election, as he launches sweeping new operational changes that degrade delivery standards and delay the mail…. The Postmaster General and top Postal Service leadership must answer to the Congress and the American people as to why they are pushing these dangerous new policies that threaten to silence the voices of millions, just months before the election.”
The New York Times reports that Pelosi and other Democratic leaders are considering cutting the House’s summer recess short in order to deal with the USPS crisis. Meanwhile, Schumer also announced today that he would be introducing legislation to ensure all election mail is treated as first class, overtime pay at USPS be restored, staffing shortages because of COVID-19 be resolved and mail-sorting machines that have been “destroyed” be put back to use.
South Korea Saw Its First Major Spike Since March
Yesterday, South Korea reported 279 new cases, the highest daily count by far since mid-March. According to the Korea Centers for Disease Control and Prevention (KCDCP), the vast majority of recent cases have been in the Seoul metro area.
Public health officials say they are concerned that, unlike in May, when the sources of small outbreaks were easily traced and snuffed out, current patterns of transmission appear more diffuse. “Now, we see signs that cases without symptoms or with mild symptoms, undetected for some time, may have been silently spreading in the local community, leading to simultaneous outbreaks linked to churches, door-to-door sales, workplaces, markets and schools, especially in the Seoul metropolitan area,” said Kwon Jun-wook, the KCDCP’s deputy director, at a press briefing late last week.
However, there does seem to be at least one clear source of the virus spread: the Sarang Jeil Church in Seoul. Sarang Jeil has reported at least 193 cases among its members and contacts in the past four days, according to the Seoul metropolitan government. As the New York Times reports, the Sarang Jeil Church has a controversial recent history and a contentious relationship with the government of President Moon Jae-in. Earlier today, the Seoul metro government said it would sue church leader Reverend Jun Kwang-hoon for spreading false rumors about the epidemic, among other violations of disease-control law.
The Courts Kept Trying to Fix the U.S. Immigration Detention Center Travesty
COVID-19 has apparently been spreading through the Mesa Verde ICE (U.S. Immigrations and Customs Enforcement) Processing Center for weeks while officials refused to test detainees. When Federal District Court Judge Vince Chabria found out about this on Friday, he ordered all detainees and staff be tested immediately, according to the L.A. Times. Initial results came back yesterday: of 104 detained people at the Bakersfield, Calif. facility, at least 54 are positive for the virus.
This is yet another disturbing chapter showing how the U.S. government’s poor treatment of immigrants has been thrown into relief by the pandemic. As my colleague Jasmine Aguilera reported on Friday, at least 120 children were still held in detention (as of last Thursday), more than two weeks after the July 27 deadline set by a court order requiring ICE to release them because of the health risk posed by COVID-19.
Those children are not at the Bakersfield location; they are in facilities located in Karnes City and Dilley, Texas, and in Leesport, Pa. However, there is COVID-19 spreading in the two Texas locations as well: according to ICE data, 23 immigrants detained in Karnes City have tested positive, along with three in Dilley, Texas, according to ICE data. It’s unsurprising, given the propensity of this virus to spread rapidly through groups of people gathered in close, indoor proximity.
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com.
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